Citation

Erten E. Noro Psikiyatr Ars 2021; 58: S31-S40.

Copyright

(Copyright © 2021, Turk Noro-Psikiyatri Derneginin Yayin Organidir)

DOI

10.29399/npa.27408

PMID

unavailable

Abstract

The World Health Organization reported a lifetime prevalence of 2.4% for BD-I, BD-II and sub-threshold types of bipolar disorder (BD). Depressive episodes are more common than manic episodes for many BD patients. Studies show that depressive mood persists in 2/3 of life, even if they are under treatment. It may be difficult to diagnose BD in the event of depression in the first episode. The correct diagnosis and the treatment can be delayed for 6-8 years, and even longer if disorder starts in adolescence. It is reported that 40% of the patients who were initially diagnosed as unipolar were later diagnosed as BD. The features that enable us to diagnose BD depressive episode: 1) family history of BD or psychosis 2) early onset with depression 3) cyclothymic temperament characteristics 4) four or more depressive episodes in 10 years 5) agitation, anger, insomnia, irritability, excessive talkativeness or other 'mixed' or hypomanic features or psychotic symptoms during depressive episode, 6) clinical 'worsening' caused by the appearance of mixed symptoms after AD treatment 7) suicidal thoughts and attempts 8) substance abuse 9) hypersomnia in the depressive episode or sleeping too much during the day, overeating, psychomotor agitation. The number of studies conducted on BD depressive treatment is limited, the information was obtained by excluding this group from the studies or by compiling the information obtained from the treatment of unipolar depression. In this review, acute and maintenance treatment of the depressive episodes of BD will be discussed according to the treatment algorithms. © 2021 by Turkish Association of Neuropsychiatry-Available online at www.noropskiyatriarsivi.com.

Language: en

Keywords

human; systematic review; Review; quality of life; head injury; Treatment; insomnia; ketamine; suicide attempt; bipolar depression; glutathione; sleep deprivation; antidepressant agent; cognitive defect; serotonin uptake inhibitor; tricyclic antidepressant agent; venlafaxine; quetiapine; psychotropic agent; alprazolam; dopamine; electroconvulsive therapy; neurotransmission; family history; nonsteroid antiinflammatory agent; carbamazepine; olanzapine; risperidone; benzodiazepine; lorazepam; valproic acid; hypertension; lamotrigine; glucose blood level; maintenance therapy; ziprasidone; agitation; opiate addiction; thyroid function test; acetylcysteine; phototherapy; obsessive compulsive disorder; oxcarbazepine; sulpiride; vagus nerve stimulation; electroencephalography; dizziness; aripiprazole; brain depth stimulation; thyroxine; nerve cell plasticity; serotonin noradrenalin reuptake inhibitor; pramipexole; high density lipoprotein; low density lipoprotein; antidepressant activity; lurasidone; cognitive behavioral therapy; sleep latency; Bipolar disorder I; Bipolar disorder II